Suicide rates across the world

The World Health Organization (WHO) compiles and disseminates data on mortality and morbidity reported by its Member States, according to one of its mandates. Since the WHO's inception in 1948, the number of Member States has grown continually and so has the WHO mortality data bank. From 11 countries reporting data on mortality in 1950, the number of countries involved increased to 74 in the year 1985. More than 100 Member States reported on mortality at some point in time.
Data from developed countries (mostly in the North of Europe and of America, and a few countries of the Western Pacific Region) are received on a mostly regular basis. Most developing countries (in Latin America, Asia and in the Eastern Mediterranean Region) report on an irregular basis; very few countries in Africa regularly report on mortality to WHO.

Deaths associated with suicide are an integral part of the WHO mortality data bank. Throughout consecutive editions of the International Classification of Diseases (ICD-6 to ICD-10), the category name and code of suicide have remained relatively stable. Suicide data are reported in absolute numbers along with the mid-year population of a country. The suicide rates are usually represented by country, year, sex, and age group. The most recent data available to the WHO can be accessed through its web site (www.who.int).

The official figures made available to WHO by its Member States are based on death certificates signed by legally authorized personnel, usually doctors and, to a lesser extent, police officers. Generally speaking, these professionals do not misrepresent the information. However, suicide may be hidden and underreported for several reasons, e.g. as a result of prevailing social or religious attitudes. In some places, it is believed that suicide is underreported by a percentage between 20% and 100%. This underlines the importance of bringing about corrections and improvement on a world wide basis.

In contrast to data on completed suicide, no country in the world reports to WHO official statistics on attempted suicide (and most probably countries do not collect them), which makes it impossible to relate national trends of suicide to national trends of attempted suicide. In the absence of national data, one is forced to rely on local studies, which vary considerably, for instance in terms of the operational definition of attempted suicide. The WHO/EURO Multicentre Study on Suicidal Behaviour (1) constitutes a major step forward in this area.

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EPIDEMIOLOGICAL CONSIDERATIONS
SUICIDE AND MENTAL DISORDERS
IMPLICATIONS FOR PREVENTION
References
EPIDEMIOLOGICAL CONSIDERATIONS
According to calculations based on data reported to WHO by its Member States, in 1998 suicide represented 1.8% of the global burden of disease and it is expected to increase to 2.4% by the year 2020. Suicide is among the 10 leading causes of death for all ages in most of the countries for which information is available. In some countries, it is among the top three causes of death for people aged 15-34 years.

In the year 2020, approximately 1.53 million people will die from suicide based on current trends and according to WHO estimates. Ten to 20 times more people will attempt suicide worldwide (2). This represents on average one death every 20 seconds and one attempt every 1-2 seconds.

The highest suicide rates for both men and women are found in Europe, more particularly in Eastern Europe, in a group of countries that share similar historical and sociocultural characteristics, such as Estonia, Latvia, Lithuania and, to a lesser extent, Finland, Hungary and the Russian Federation. Nevertheless, some similarly high rates are found in countries that are quite distinct in relation to these characteristics, such as Sri Lanka and Cuba.

According to the WHO regional distribution, the lowest rates as a whole are found in the Eastern Mediterranean Region, which comprises mostly countries that follow Islamic traditions; this is also true of some Central Asian republics that had formerly been integrated into the Soviet Union. Curiously enough, when the data are separated by WHO region, the highest rates in each region, with the exception of Europe, are found in island countries, such as Cuba, Japan, Mauritius and Sri Lanka.

In Figure 1, global suicide rates (per 100,000 population) have been calculated starting from 1950. Deaths reported by countries in each year were averaged and projected in relation to the global population over 5 years of age at each respective year. An increase of approximately 49% for suicide rates in males and 33% for suicide rates in females can be observed between 1950 and 1995.

Figure 1
Global suicide rates since 1950 and projected trends until 2020
The increase in these global suicide rates must be interpreted with caution. On the one hand, it might reflect the fact that since the end of the USSR (which had an overall rate below the average), some of its former republics (particularly those with the highest rates in the world) started to report individually, thus inflating the global rate. On the other hand, figures for 1950 were based on 11 countries only, and this gradually increased up to 1995, when the estimates were based on 62 countries that reported on suicide. These 62 countries as a whole probably have higher rates, are more concerned with them and have a higher tendency to report on suicide mortality than countries where suicide is not perceived as a major public health problem.

Although it is customary in the suicidology literature to present total rates of suicide for both men and women combined, it should be noted that the current general epidemiological practice is to present rates according to sex and age, particularly when important differences (in terms of figures or risk factors) across sex or age groups exist. This is precisely the situation in relation to suicide; suicide rates of men and women are consistently different in most places, as are rates in different age groups.

Figure 1 also highlights the relatively constant predominance of suicide rates in males over suicide rates in females: 3.2:1 in 1950, 3.6:1 in 1995 and 3.9:1 in 2020. There is only one exception (China), where suicide rates in females are consistently higher than suicide rates in males, particularly in rural areas (3).

There is a clear tendency for suicide rates to increase with age (Figure 2). By comparison with a global suicide rate of 26.9 deaths per 100,000 for men in 1998, the rates for specific age groups start at 1.2 (in the age group 5-14 years) and gradually increase up to 55.7 (in the age group over 75 years). The same positive relationship between age and suicide rates is observed in females: for an overall rate of 8.2 in 1998, specific age group rates grow from 0.5 per 100,000 (in the age group 5-14 years) to 18.8 (in the age group over 75 years).

Figure 2
Distribution of suicide rates (per 100,000) by gender and age, 1998
In spite of the wide and appropriate use of rates, the information conveyed by them alone can be misleading, particularly when comparing data across countries or regions with important differences in the demographic structure. As indicated earlier, the highest suicide rates are currently reported in Eastern Europe; however, the largest numbers of suicides are found in Asia. Given the size of their population, almost 30% of all cases of suicide worldwide are committed in China and India alone, although the suicide rate of China practically coincides with the global average and that of India is almost half of the global suicide rate. The number of suicides in China alone is 30% greater than the total number of suicides in the whole of Europe, and the number of suicides in India alone (the second highest) is equivalent to those in the four European countries with the highest number of suicides together (Russia, Germany, France and Ukraine).

Given the relatively narrow differences in the population of males and females in each age group, the large predominance of suicide rates among males is also found in relation to the actual number of suicides committed.

It is in relation to age, however, that the most striking changes are perceived when we move from rates to total numbers. Although suicide rates can be between six and eight times higher among the elderly, as compared with young people, currently more young people than elderly people are dying from suicide, globally speaking. Currently, more suicides (55%) are committed by people aged 5-44 years than by people aged 45 years and older (Figure 3). Accordingly, the age group in which most suicides are currently completed is 35-44 years for both men and women.

Figure 3
Distribution of suicide rates (per 100,000) by gender and age, 1998
This shift in the predominance of numbers of suicide from the elderly to young people is a new phenomenon. It becomes dramatic when one considers that the proportion of the elderly in the total population is increasing at a greater rate than the one of younger people. Also, it is not the result of a divergent modification in suicide rates in these age groups: the suicide rate in young people is increasing at a greater pace than it is in the elderly.

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EPIDEMIOLOGICAL CONSIDERATIONS
SUICIDE AND MENTAL DISORDERS
IMPLICATIONS FOR PREVENTION
References
SUICIDE AND MENTAL DISORDERS
The presence of a mental disorder is an important risk factor for suicide. It is generally acknowledged that over 90% of those who committed suicide had a psychiatric diagnosis at the time of death.

In order to discuss the implications of psychiatric diagnosis for suicide prevention, we have undertaken a systematic review of studies reporting diagnoses of mental disorders. Preliminary findings are to be found elsewhere (4,5).

The review included 31 papers, published between 1959 and 2001 world wide. In total, 15,629 cases of suicide in the general population (above the age of 10 years, both sexes) were identified. Papers focusing only on specific age groups, such as young people or the elderly, or only on specific disorders, such as depression or schizophrenia, were excluded; usually these studies included a rather small sample size. All studies retained refer to people with or without history of admission to mental hospitals (47.5% versus 52.5%, respectively). The diagnostic methods included both diagnoses established while the person was still alive and post-mortem diagnoses based on e.g. psychological autopsies (6). All diagnoses of mental disorders were made on the basis of ICD (8, 9 or 10) or DSM (III, IIIR or IV) and converted to general categories common to both systems.

It is noteworthy that the geographical and cultural representation of the cases was limited, since 82.1% of the cases originated from Europe and North America, whereas cases of Asian countries (including Australia and New Zealand) constituted the remaining part.

The overall results showed that 98% of those who committed suicide had a diagnosable mental disorder, and in this paper we will concentrate on the differences between the psychiatric diagnoses of general populations and of populations which had been admitted to mental hospitals. Out of the 15,629 cases reviewed, 7,424 cases (47.5%) had been admitted at least once to a psychiatric hospital or ward (heretofore designated as PIP), whereas there was no indication of this type of admission in 8,205 cases (52.5%), heretofore designated as GP.

Table 1 shows the distribution of the diagnoses found in all cases. It should be noted that in some studies on GP (but in none on PIP) multiple diagnoses were established, thus making the number of diagnoses greater than the number of cases.

Table 1
Diagnoses of mental disorders in cases of suicide in psychiatric inpatient and general populations
Unsurprisingly, a psychiatric diagnosis was made in the majority of people who committed suicide; in 3.2% of the cases of GP and in 0.1% of PIP a psychiatric diagnosis was not established, which leaves it open whether there were no good conditions or information for the establishment of a psychiatric diagnosis or whether the person did not actually have a diagnosable mental disorder.

Apart from the predominance of mood disorders in both groups (however, with an important difference between them), there are major differences in the prevalence of psychiatric diagnoses across these two groups, as highlighted below (Figures 4 and 5):

Mood disorders (actually, depression, since a minority of cases of mania was identified in association with suicide) were the most frequently found mental disorders in both types of populations; however, it amounted to 20.8% of PIP and 35.8% of GP, a much smaller percentage than what is currently held.
Schizophrenia is the second most frequent diagnosis in the PIP (19.9%), but only the fourth in GP (10.6%).
Substance-related disorders (actually, alcohol-related disorders, in the vast majority of the cases) was the second most frequent diagnosis in GP (22.4%) but only the sixth in PIP (9.8%).
Personality disorders were third both in PIP (15.2%, a percentage quite similar to organic mental disorders) and in GP (11.6%).
Both organic mental disorders and other psychotic disorders each represented more than 10% of all diagnoses in PIP (15% and 10.4%, respectively), but were below 1% in GP (1% and 0.3%, respectively).
All other individual disorders represented less that 5% of all diagnoses, with the exception of anxiety/somatoform disorders in GP (6.1%, but only 2.5% in PIP).
The combination of the two major psychotic disorders (schizophrenia and other psychotic disorders) in PIP amounts to 30.3% of all cases, which is 50% higher than mood disorders, in this group. If we transfer the few cases of mania from mood disorders into psychotic disorders, this gap is further increased.
The comorbidity of mood disorders with substancerelated disorders (in practice, depression and alcoholism) was the most frequently found by those GP studies that recorded multiple diagnoses (all PIP studies gave only one main diagnosis).
Figure 4
Suicide and mental disorders: distribution of diagnoses in studies with psychiatric inpatients
Figure 5
Suicide and mental disorders: distribution of diagnoses in studies with general population
Top
EPIDEMIOLOGICAL CONSIDERATIONS
SUICIDE AND MENTAL DISORDERS
IMPLICATIONS FOR PREVENTION
References
IMPLICATIONS FOR PREVENTION
The data presented above clearly point out the appropriateness of the treatment of mental disorders as a major component of suicide prevention programmes. However, on the one hand, suicide is found associated with a variety of mental disorders, each one of them with a different therapeutic approach, thus making a 'blanket approach' probably unsound. On the other hand, no single mental disorder is found in association with suicide with such a magnitude as to have any significant impact in national suicide rates, should its treatment be even at an impossible 100% of effectiveness.

Although the data presented here included all the studies found in the whole scientific literature in English, through the methodology described earlier on, more than 80% of the cases come from three countries only, namely Denmark, UK and USA. It is quite possible that a different diagnostic distribution be found in other countries or regions. Actually, there are indications that in the Baltic region alcohol-related disorders have a stronger association with suicide than in other regions (7) and that in Asia less suicides are associated with depression, in comparison with Western countries (8,9). According to these authors, in Asian countries there are more suicides of the impulsive type, committed within hours of the triggering factor, than what is usually seen in industrialized countries.

Therefore, a sound suicide prevention strategy should definitely include the treatment of the disorders most fre- quently associated with suicide, on a local basis. In the absence of the relevant information, it should include the treatment of at least schizophrenia, depression and alcohol- related disorders as a main component, but should not overlook other components more dependent on the social and physical environment, as proposed by the WHO human-ecological approach (10).

According to this approach, other actions to prevent suicide include:

Control of the availability of toxic substances and medicines;
Detoxification of domestic gas and car emissions;
Restricted access to guns;
Responsible media reporting about suicide;
Erection of barriers to deter jumping from high places.
At any rate, suicide remains a major public health problem, nevertheless preventable, and action for its prevention calls for a coordinated multisectoral approach. In view of the close association between suicide and mental disorders, psychiatrists are in a particularly strategic position to lead effective suicide prevention programmes.

Top
EPIDEMIOLOGICAL CONSIDERATIONS
SUICIDE AND MENTAL DISORDERS
IMPLICATIONS FOR PREVENTION
References
References
1.
Schmidtke A, Bille-Brahe U, De Leo D, et al., editors. Suicidal behaviour in Europe: results from the WHO/EURO multicentre study on suicidal behaviour. Bern: Hogrefe & Huber; 2001.
2.
World Health Organization. Figures and facts about suicide. Geneva: World Health Organization; 1999.
3.
Phillips MR. Li X. Zhang Y. Suicide rates in China, 1995–99. Lancet. 2002;359:835–840. [PubMed]
4.
Bertolote JM. Fleischmann A. Suicide rates in China. Lancet. 2002;359:2274. [PubMed]
5.
Bertolote JM. Fleischmann A. Suicide and mental disorders in the general population. Submitted for publication.
6.
Beskow J. Runeson B. Asgard U. Psychological autopsies: methods and ethics. Suicide and Life-Threatening Behavior. 1990;20:307–323. [PubMed]
7.
Wasserman D. Värnik A. Suicide-preventive effects of perestroika in the former USSR: the role of alcohol restriction. Acta Psychiatr Scand. 1998;98(Suppl. 394):1–4. [PubMed]
8.
Phillips MR. Suicide rates in China. Lancet. 2002;359:2274.
9.
Vijayakumar L. Rajkumar S. Are risk factors for suicide universal? A case-control study in India. Acta Psychiatr. Scand. 1999;99:407–411. [PubMed]
10.
World Health Organization. Primary prevention of mental, neurological and psychosocial disorders. Geneva: World Health Organization; 1998.

Questions

How do I upload photo's to my web page?
How do I upload final cut or quicktime movies to my web page?
Can I put a message onto each page of the web site announcing it's under construction?
How do I place links onto the web page?
How can I link back to the homepage from other pages?

to meet up!

i thought i would guest author you blog and do some shamless self promoting!

we need to get together and talk about that thing!

also visit the link for my blog page (leegavin.blogspot.com)

and my page for realted to one of my ideas (artanonymous.blogspot.com)

also if you would like to send some pictures to me via mobile of email, of anyhting you may have saved on your computer or mobile!

thank you tony, i wish you the best of luck!

Tutorial

Well what did I get out of yesterdays tutorial?
I discussed the fact that I am changing my approach to better suit my style of photography, Adam reminded me that I should continue with my curiosity towards the human form and what I see people doing to themselves, this will be great for building my portfolio.

I said how the approach I've taken to research this brief is somewhat confusing to me, and I might revert back to my old way's! we will see.

Thing's to focus on, fetting the blog read by a wider audience, what can draw people in?

More links, the web page, an email, podcast etc.

I need people to comment!

Average Life expectancy

Thursday, 9 May, 2002, 18:06 GMT 19:06 UK
Life expectancy to soar
Erzsebet Keri, 73, being strapped to the wing of a plane
There is "no sign" of a ceiling on life expectancy
People are set to live increasingly long lives, and reaching 100 will soon be "commonplace", say experts.

They say that although there is no prospect of immortality, the trend for living increasingly long lives looks set to continue.

Centenarians - 100-year-olds - will become unexceptional within the lifetimes of people alive today, according to Jim Oeppen, from Cambridge University, UK, and Dr James Vaupel, from the Max Plank Institute for Demography in Rostock, Germany.

They said there was no sign there was a natural limit, as some experts had predicted.

Each time one has been suggested, it has been exceeded within five years.

Increased life expectancy

The researchers' suggestion that life expectancies could rise is based on patterns seen since 1840.


This is far from eternity: modest annual increments in life expectancy will never lead to immortality

Researchers Jim Oeppen and Dr James Vaupel
Since then, the highest average life expectancy has improved by a quarter of a year every year.

If that trend continues, the researchers say people in the country with the highest life expectancy would live to an average age of 100 in about six decades.

The researchers wrote in the journal Science: "This is far from eternity: modest annual increments in life expectancy will never lead to immortality.

"It is striking, however, that centenarians may become commonplace within the lifetimes of people living today."

Average lifespan around the world is around double what it was 200 years ago. It is now around 65 for men and 70 for women.

Japanese women are currently the likeliest to live long lives, on average reaching 84.6 years of age.

Japanese men are the second longest male survivors, reaching an average age of 77.6 years old.

'No ceiling'

The British rank well down the list. Men come in at 14th in the world table, living to an average age of 75 while women are in 18th place, living on average to 79.9.

In France, there is a big difference between men and women's life expectancy.

Men came 16th in the world table, with an average lifespan of 74.9, with French women in fourth place with a life expectancy of 82.4 years.

British women
British women have a life expectancy of 79.9
Mr Oeppen, senior research associate at the Cambridge Group for the History of Population and Social Structure, said: "One of the assumptions is that life expectancy will rise a bit and then reach a ceiling it cannot go through.

"But people have been assuming that since the 1920s and it hasn't proved to be the case.

"If we were close to the ceiling we might expect the survival of Japanese women now to be improving at a slower rate. But the improvement in Japan is among the fastest in the world."

He added: "I think there is a ceiling, but we don't know where it is. We haven't got there yet."

Mr Oeppen and Dr Vaupel said their predictions meant even the highest forecast for numbers of elderly people in the future could be too low, affecting decisions over pensions, health care, and other social needs.

Political reaction

Frank Field, Labour MP for Birkenhead and chairman of the all-party committee on pensions, welcomed the report.

He called for an independent body to be set up to examine the need for an increase in the retirement age.

He said: "If you look at life expectancy in 1948, when the state pension was introduced, and take that as a reasonable length of time to receive a pension, you would have a retirement age of 74 today."

Yoga Soo 2

http://www.yogasoo.org/aboutme.htm

This is Yoga Soo's web site if your interested!

Yoga Soo

Well the other week, following on with what I was saying about using this as some sort of spring board into new things, I meet this woman at work, she came in to get some photocopies done, I of course gave her assistance, she was very thankful.

Well being nosey I spotted her photocopies, they were of some yoga positions. I made the mistake of asking her if she was into dance? (I know what has that got to do with yoga)?

She corrected me and said it was yoga, now Soo is not a young woman (age wise), but had a really good body, I know that sounds pervy, but it really is'nt.

I then asked if she had any interest in having some photo's taken of her in some yoga poses, (of course I was thinking of myself).
She said that she had already got some on the internet, she already has a web page, but she would be interested in updating them. Hooray, I thought.

I will now be arranging a day to do a shoot with her, This will also be a begging of something that has interested me for a while, how we can use our bodies to do some amazing things, I hope I can capture that in these images!

Wait and see..

Continuing into the future

I have decided that this brief/project will continue into the future, I will use this as the first steps to an ongoing body of work/portfolio.
I have always been interested in the human form and the amount of diversity the human form has, we are stuck with our bodies and we use them in many different ways. I will explore this far beyond this brief and even the degree.
I think I am beggining to find my way.. scary stuff!

Dreamweaver

Finally found out how to place my Photoshop made buttons into dreamweaver and launch them onto the web page.
I have now assigned each button with its link page, so the rest is all about content.
I will also have to add some links, such as an email, this blog, possibly a podcast? etc.

People

I am finding it very difficult to decide on what type of Male/Females I should be taking Photo's of! I as a personal thing, like to approach what I call interesting people, people that have something about them that stands out from what I call the norm!! (whatever taht means)?

Alot of people get a bit defensive when asked for a portrait, but I don't want to take them without their permission!

Of course I can use the rest of the photography group?

Blog action day

I have also just commited to the blog action day, which was recommended by Mr Gavin.

http://blogactionday.org/commit

Web Content

This is the plan, I am going to start recording male and female Photo's for the web site, they are going to range from a baby in the womb to 100 years of age (for both sexes).

Of course I can see that this will be a very difficult task to undertake, but as the title Shifting Destinations denotes, It may not be entirely true!

Shifting/Destinations

Shifting:- Move or cause to move from one place to anotherover a small distance.
"change the emphasis, direction or focus"
Be avasive or indirect.
something that is constantly changing, unpredictably.

Destinations:- Being a place that people will make a special trip to visit.
"the place to which something or someone is going or being sent"
"origin":- or original sense, the action of intending someone or something for a particular purpose.

From the dictionary.

These meanings hold alot of truth in what I am aiming to achieve, I have been changing direction through the progression of the research and through my own thoughts on what the content of my web page should contain.
It makes it very difficult to stay focused on anything which is frustrating aswell as liberating.

Guardian Media Guide 2007

I have been told that this is the directory for every important contact you need to know in the field of media, so I have purchased this years copy from Amazon.co.uk.

Google website submission

http://www.google.com/addurl/

Buisiness Card

I am going to produce a number of buisiness cards to distribute around, announcing the site (when it's up and running)!
I have made up a design for the card:- as above, telling people a little bit about myselfand dangling a carrot for them?
What they won't know is that what they will find on the web site will be pure fiction to them! but maybe not to me?
There will be different age brackets to choose from, they can of course choose there current age, a younger age or even an older age to discover something about themselves, which of course they may not!
I am hoping to recieve comments back from there discoveries or lack of, what ever the case may be.

Tutorial

Well I had my first tutorial on Monday 01/10/07, It was a group tutorial and I chose to take the 1pm - 2pm slot.
When it came to talk about my ideas I was not completely honest with my intentions, but that is all part of the illusion, as we are "shifting Destinations" I thought it would be good to be vague about my real intentions.
For two reasons, 1, I am not completely sure about the finer points, and 2, I want the final announcement to be a suprise at the critique.

Of course certain people that are helping me to get to where I want to be will have some idea, but that is all.

First reply

Please find a GQ Media Pack attached
Best wishes
Al

-----Original Message-----
From: Charlotte Zamani
Sent: 02 October 2007 13:54
To: Alice Valentine
Subject: FW: Target Audience/Demographic


Would you kindly send him a media pack please?

Charlotte x

Magazines

I have sent off a generic E-mail to a number of magazines asking them about their target audience/demographic.
I am hoping they will respond, this will get me started on who to pitch certain information and images to on the web page. I will header them with a brief description about what catergory they come under.
Below are the people I have contacted so far:-

general@fhm.com
charlotte.zamani@condenast.co.uk
belindap@ripitup.com.au
julie.lasky@id-mag.com
marketing@wallpaper.com
comments@125magazine.com
mel.hutcheon@hf-uk.com
countryliving@hearst.com
woiadvertising@condenast.co.uk

Emails

I have just been sent an E-mail from my sister inlaw Kellie from Australia, It holds some relevance I think to this brief.


hey donk,

found this article on an artist frank warren who leaves blank postcards around new york with the intention for people to write their secrets on. they then forward them to him and he posts them on his website www.postsecret.com

you probably already know this but if not have a look.

there are some interesting ones like:

"when i was 16 i found my mothers vibrator. i returned it a year later"


eeeeeeeeeeeeeeeeeeeww!!!!!!!!!!!!!!!!!




:-)